Physician Forms

To take advantage of electronic prior authorization (ePA), please submit your prior authorization request to Express Scripts through your choice of online portals, Express Scripts' own ExpressPAth, Surescripts' ePA or CoverMyMeds. If you are unable to use our website, please call us at 800.753.2851 to submit a verbal prior authorization request.

If you are unable to use ePA and can't submit a request via telephone, please use our general request form and fax it to the number on the form.

To view a list of drugs with a Prior Authorization requirement, click here.